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The New Zealand Medical Journal

 Journal of the New Zealand Medical Association, 11-June-2010, Vol 123 No 1316

This Issue in the Journal
Preventability of pre-hospital trauma deaths in southern New Zealand
James A Falconer
This study was done on the pre-hospital preventability of trauma deaths in New Zealand as no similar study has been done despite trauma being a leading cause of death in this country. Post-mortem reports were examined and scored with a well recognised scoring system to determine preventability of the deaths in the study region (Otago and Southland from 2000 to 2004). Most of the study population was found to have multiple anatomical regions injured, with the head and chest the most frequently fatally injured regions. Most deaths were in males under the age of 35, and the majority of the study population died as a result of motor vehicle accidents. The majority of the study population had non-survivable injuries however nearly half (45%) had either survivable (10%) or potentially survivable injuries (35%). This is similar to other comparable international studies.
Patterns of lower limb fractures sustained during snowsports in Otago, New Zealand
Alistair Patton, James Bourne, Jean-Claude Theis
We describe the nature and circumstances of leg fractures sustained during skiing and snowboarding, that required operative fixation at a single orthopaedic unit in New Zealand from 2002 to 2008.
Ethnicity of severe trauma patients: results of a population based study, Auckland, New Zealand 2004
Gowan Creamer, Ian Civil, Alex Ng, David Adams, Shas Čačala , Timothy Koelmeyer, John Thompson
Ethnicity is a factor in severe injury and mortality (death) rates in Auckland. Our study findings show that Māori and Pacific people had increased risk of severe injury and injury-related mortality in 2004.
Intensive care triage in Australia and New Zealand
Paul J Young, Richard Arnold
We conducted a web-based survey of Australian and New Zealand intensive care doctors measuring demographics, details of recent triage decisions and attitudes towards various triage scenarios. This survey demonstrated that there are significant differences between the views of intensive care practitioners in Australia and those in New Zealand with respect to a range of common intensive care triage scenarios with those in New Zealand tending to be more selective in their admission criteria. Despite these differences, we did not demonstrate any difference in the proportion of referrals to the intensive care unit that were refused.
Illness severity scoring for Intensive Care at Middlemore Hospital, New Zealand: past and future
Susan L Mann, Mark R Marshall, Alec Holt, Brendon Woodford, Anthony B Williams
Scoring systems are one of the tools used in intensive care to allow study of progress in medical techniques and treatment over time. Middlemore Hospital caters for a unique population, and this is reflected in the diverse nature of admissions to our intensive care unit. Until recently, we have relied upon an international gold-standard scoring system to help us benchmark the outcomes we are achieving in our intensive care unit. In this study we show how this scoring system has become less helpful over time. We suggest some new approaches that might provide a more realistic reflection of practice and outcomes in our population.
Capturing outcomes following injury: a New Zealand pilot study
Sarah Derrett, Gabrielle Davie, Shanthi Ameratunga, John Langley
To identify ways of improving outcomes after injury we need to know what promotes good outcomes and reduces poor outcomes. Few studies have followed the impact of injury on individual New Zealanders over time. We were unsure if injured New Zealanders would be willing to take part in a study of outcome following injury if the initial invitation came from their insurer—the ACC. Two-thirds of eligible people contacted were willing to take part in a pilot study and participants included those with a range of injury types and causes. Following the pilot study, improvements were made to the main ‘Prospective Outcomes of Injury Study’ which is now underway.
Unintentional falls at home among young and middle-aged New Zealanders resulting in hospital admission or death: context and characteristics
Bridget Kool, Shanthi Ameratunga, Wayne Hazell, Alex Ng
This study describes the characteristics and contexts of unintentional falls at home among adults aged 25–59 years that resulted in admission to hospital or death during a 12-month period in Auckland, New Zealand. Of the 335 people who fell during the 12 month period and agreed to be interviewed (in the case of death or major injury a family member was interviewed), 36% fell on stairs/steps, 31% fell on the same level, 13% of falls involved ladders or scaffolding, and 11% fell from buildings or structures. The majority of falls (81%) occurred in the individual’s own home. While this analysis was not designed to identify the specific causes of falls, 24% of participants had consumed ≥2 drinks in the 6-hours preceding the fall, and 24% were on ≥2 prescription medications. The findings reveal several important contextual factors that can be targeted to prevent fatal and serious non-fatal falls at home among this age group.
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